Medical Billing Specialist Resume Example
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MEDICAL BILLING SPECIALIST
Professional Summary
Medical Billing Specialist with 7 years of experience in fast-paced, multiple-client medical billing company serving large private practice conglomerates and outpatient clinics. Researched denied claims and submitted appeals. Familiar with health billing and collections. Reliable and competent Medical Billing professional with exceptional data entry and customer service skills. Driven Medical Biller motivated to perform beyond expectations.
Skills
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Work History
Medical Billing Specialist04/2019 to 01/2021
Oklahoma Mental Health Council – Weatherford , OK
Oklahoma Mental Health Council – Weatherford , OK
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Performed targeted collections on past due accounts aged over 90 days.
- Applied more than 80 paper check payments per week.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Posted and adjusted payments from insurance companies.
- Trained new employees on multiple medical billing programs and data entry software.
- Performed billing and coding procedures for inpatient services.
- Located errors and promptly refiled rejected claims.
- Maintained and updated authorization tracking spreadsheet to help organize current authorization information.
- Evaluated patients' financial status and established appropriate payment plans.
- Precisely evaluated and verified benefits and eligibility.
- Accurately posted and sent out all medical claims.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients by determining financial assistance available and setting up payment plans.
- Researched and followed up on denied insurance claims.
- Posted payments and collections on regular basis.
- Communicated with insurance providers to resolve any denied claims and resubmit.
- Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
- Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
- Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Transferred balances to correct payers.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Analyzed medical records to satisfy insurance company mandates.
Medical Billing Specialist05/2017 to 06/2018
Oklahoma Mental Health Council – Hobart , OK
Oklahoma Mental Health Council – Hobart , OK
- Posted and adjusted payments from insurance companies.
- Located errors and promptly refiled rejected claims.
- Evaluated patients' financial status and established appropriate payment plans.
- Accurately posted and sent out all medical claims.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Assisted patients by determining financial assistance available and setting up payment plans.
- Collected payments and applied to patient accounts.
- Researched and followed up on denied insurance claims.
- Posted payments and collections on regular basis.
- Communicated with insurance providers to resolve any denied claims and resubmit.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
- Maintained current accounts through aged revenue reporting.
- Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
- Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Verified signatures and checked medical charts for accuracy and completion.
- Transferred balances to correct payers.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
Medical Billing Specialist02/2013 to 05/2017
Oklahoma Mental Health Council – Kingfisher , OK
Oklahoma Mental Health Council – Kingfisher , OK
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Posted and adjusted payments from insurance companies.
- Evaluated patients' financial status and established appropriate payment plans.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Assisted patients by determining financial assistance available and setting up payment plans.
- Collected payments and applied to patient accounts.
- Researched and followed up on denied insurance claims.
- Posted payments and collections on regular basis.
- Communicated with insurance providers to resolve any denied claims and resubmit.
- Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
- Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Transferred balances to correct payers.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Adhered to established standards to safeguard all patients' health information.
- Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
Debt Collector06/2010 to 02/2013
Mandarich Law Group – Woodland Hills , CA
Mandarich Law Group – Woodland Hills , CA
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Monitored accounts for compliance with established payment plans and flagged those in violation.
- Used skip tracing and other techniques to locate debtors.
- Delivered exceptional customer service on all calls while maintaining calm and professional demeanor in challenging circumstances.
- Maintained high volume of calls to meet demands of busy group.
- Achieved performance goals on consistent basis.
- Used scripted conversation prompts to convey current account information and obtain payments.
- Trained new team members on scripts, company services and performance strategies and provided mentoring.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
Education
High School DiplomaService High School-
City,
State
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Resume Overview
School Attended
- Service High School
Job Titles Held:
- Medical Billing Specialist
- Debt Collector
Degrees
- High School Diploma
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